Culture-negative periprosthetic joint infections

[摘要] Periprosthetic joint infections (PJI) remain a difficult and challenging complication of all joint arthroplasty surgery. The incidence of a PJI after a primary total hip replacement (THR) or knee replacement (TKR) is reported as between 2% and 2.4%.1 In Europe, the mean PJI rate is 0.8% for TKR and 1.2% for THR but considerable variation exists between countries.2 The management of a PJI is complex and expensive, requiring, in most cases, revision surgery and long-term use of antibiotics, and is associated with significant morbidity and mortality. The annual cost of PJI in the United States is expected to be around $1.6 billion by 20201 although this figure is likely to be a gross underestimate in that it only addresses direct hospital costs.3 In the majority of cases, the diagnosis of a PJI is relatively straightforward with clear clinical evidence of an infection, raised inflammatory markers such as C-reactive protein (CRP), evidence of loosening on the plain radiographs and a positive culture result from sampling.

[学科分类] 神经科学

[关键词] alpha-defensin;culture-negative periprosthetic joint infection;Dithiothreitol;interleukin 6;leucocyte esterase;next generation sequencing;polymerase chain reaction;sonication